Due to the multitude of factors mentioned, it is difficult to estimate the prevalence of HIV and syphilis within the sex worker population directly. However, rates of congenital syphilis have increased sharply within the past years, an indication of untested and untreated cases (Public Health Agency of Canada, 2022). In addition, syphilis and HIV both have significant long-term health implications, pointing to a need for new solutions. 

Recognizing that sex workers may be hesitant to disclose their occupation status, SWAP and TAN will be critical in reaching the sex worker population. By surveying and interviewing people who access SWAP and TAN services and having community partners lead this research, we hope to reach and build trust with the Hamilton sex worker community. Participants will be recruited from SWAP community events. During the interviews, community participants will have the space to self-identify as sex workers; however, they will not be asked to disclose their occupation status. Further participants will be recruited through snowball sampling, whereby participants will also be asked to refer other people they may know who may be interested in contributing to the community needs assessment. Participants will be provided an honorarium for their time, $50 for interviews and $20 for online surveys.

Rapid tests will first be rolled out at existing Hamilton Public Health community sexual health clinics, such as the Downtown clinic, the VAN mobile clinic, and community-based locations at SWAP, TAN, and the Club Hamilton Bathhouse. Rapid testing will also available at Women's Health Days events. At each of these spaces, individuals are able to access a variety of services, including harm reduction supplies and supports. Rapid testing will first be offered as point-of-care testing by clinic and event staff, through which individuals will also be able to receive immediate referrals for follow-up testing if needed, and receive information and referrals for treatment and counselling.